T Nation

TRT with High RBC

Just got some new labs back and it seems my tbc count is out of range. 5.91 (4.2 - 5.8). Hemoglobin 17.2 (13.2-17.1). Hematocrit 51.3 (38.5-50).

I take 100mg test c/ week dosed every other day and .25mg arimidex eod.

What should be done? Donate blood?

You could donate blood and you may want to consider dropping your T dose a little. Personally I wouldn’t be concerned about being a little over range. Shouldn’t be an issue. Just keep an eye on it.

what does your doctor say?

Doc didn’t even mention itâ?¦ I just saw it when i picked up the labs

Polycythemia=increased RBC. This is a side effect of TRT. I’d still think KSMan knows a lot about it. It’s not too out of range though.

I’ve heard of many guys getting a phlebotomy to solve this problem. I agree with BrentF13; give some blood and see how that works out for you.

Here is one of the less obvious questions. 3djedi, do you smoke cigarettes? Studies have shown that as little as 1/4 a pack a day will up your RBC significantly over a short period of time. The more you smoke, the high the RBC levels. I do not if the same holds true for smoking pot.

[quote]dogsoldier wrote:
Here is one of the less obvious questions. 3djedi, do you smoke cigarettes? Studies have shown that as little as 1/4 a pack a day will up your RBC significantly over a short period of time. The more you smoke, the high the RBC levels. I do not if the same holds true for smoking pot. [/quote]

No, I don’t smoke.

This may be a ridiculous question…but is polycythemia even a bad thing? I mean don’t endurance athletes blood dope to achieve this and improve their abilities to perform during endurance sports?

I also have the same side effect from TRT

The simple act of increasing the number of RBC’s in the blood stream makes blood thicker, which can also make it clot more readily.[14] This increases the chances of heart attack, stroke, and pulmonary embolism, which has been seen in cases where there is too much blood reintroduced into the blood stream.

This is pretty cool:

In 1993, U.S. Special Forces commanders at Fort Bragg started experimenting with blood doping, also known as blood loading. Special forces operators would provide two units of whole blood, from which red blood cells would be extracted, concentrated, and stored under cold temperatures. Twenty-four hours before a mission or battle, a small amount of red blood cells would be infused back into the soldier. Military scientists believe that the procedure increases the soldiers’ endurance and alertness because of the increase in the blood’s capability to carry oxygen.

In 1998, the Australian Defence Forces approved this technique for the Special Air Service Regiment. Senior nutritionist at the Australian Defence Science and Technology Organization Chris Forbes-Ewan is quoted as saying that, unlike in sport, “all’s fair in love and war.” “What we are trying to gain is an advantage over any potential adversary,” Forbes-Ewan said. “What we will have is a head-start.”

Exactly why i saw it as an advantage.

[quote]3djedi wrote:
The simple act of increasing the number of RBC’s in the blood stream makes blood thicker, which can also make it clot more readily.[14] This increases the chances of heart attack, stroke, and pulmonary embolism, which has been seen in cases where there is too much blood reintroduced into the blood stream.

This is pretty cool:

In 1993, U.S. Special Forces commanders at Fort Bragg started experimenting with blood doping, also known as blood loading. Special forces operators would provide two units of whole blood, from which red blood cells would be extracted, concentrated, and stored under cold temperatures. Twenty-four hours before a mission or battle, a small amount of red blood cells would be infused back into the soldier. Military scientists believe that the procedure increases the soldiers’ endurance and alertness because of the increase in the blood’s capability to carry oxygen.

In 1998, the Australian Defence Forces approved this technique for the Special Air Service Regiment. Senior nutritionist at the Australian Defence Science and Technology Organization Chris Forbes-Ewan is quoted as saying that, unlike in sport, “all’s fair in love and war.” “What we are trying to gain is an advantage over any potential adversary,” Forbes-Ewan said. “What we will have is a head-start.”
[/quote]

We have had some guys here with high hematocrit who were getting serious complications. The levels that a young healthy guy can tolerate might be a serious problem for older guys with arteries that are not supple any more. If the implications of that don’t mean anything to you, you do not understand the mechanics how blood flows through the arteries. The arteries need to expand, the muscles that surround the artery need to relax, allowing the expansion, to absorb a pulse of blood, then the muscles need to contract behind the pulse of blood. If this is impaired, a component of hardening of the arteries and increased blood pressure, a combination with thicker blood can create problems with impaired circulation. Note that Aspirin or other blood thinners are used to compensate for problems of this nature. In that situation, higher hematocrit or RBC can be a step in the dead direction.

Note that endothelial dysfunction and arterial scarring has an obvious role in reducing elasticity of the arteries. So does the muscle tone of the muscles in the arteries. Low testosterone has a negative effect on arterial muscle tone.

I totally agree KSMan and am familiar with arterial blood flow. However i was not aware that high RBC’s could cause these complications. What can be done for someone who has high RBC count besides donating blood?

[quote]KSman wrote:
We have had some guys here with high hematocrit who were getting serious complications. The levels that a young healthy guy can tolerate might be a serious problem for older guys with arteries that are not supple any more. If the implications of that don’t mean anything to you, you do not understand the mechanics how blood flows through the arteries. The arteries need to expand, the muscles that surround the artery need to relax, allowing the expansion, to absorb a pulse of blood, then the muscles need to contract behind the pulse of blood. If this is impaired, a component of hardening of the arteries and increased blood pressure, a combination with thicker blood can create problems with impaired circulation. Note that Aspirin or other blood thinners are used to compensate for problems of this nature. In that situation, higher hematocrit or RBC can be a step in the dead direction.

Note that endothelial dysfunction and arterial scarring has an obvious role in reducing elasticity of the arteries. So does the muscle tone of the muscles in the arteries. Low testosterone has a negative effect on arterial muscle tone. [/quote]

Reduced iron intake might help if iron levels are high.

How do you reduce your iron intake?

[quote]3djedi wrote:
Just got some new labs back and it seems my tbc count is out of range. 5.91 (4.2 - 5.8). Hemoglobin 17.2 (13.2-17.1). Hematocrit 51.3 (38.5-50).

I take 100mg test c/ week dosed every other day and .25mg arimidex eod.

What should be done? Donate blood?[/quote]

You cannot donate blood now. Its out of range – been there, tried that.

You have to get your doc to order a therapeutic phlebotomy. He will also want to do a bone marrow biopsy to see why this is happening (and to get a referral fee from one of his bro-docs).

Either stop TRT or plan on phlebotomy every couple of months. It comes with the therapy.

[quote]gregpet wrote:
How do you reduce your iron intake? [/quote]

Look at prepared food labeling for added iron. Breads, cereals etc have added iron and other things that are there for the needs of children. This can be too much for men.

Just donated blood and they said my hemoglobin was 16.1. 10 days ago it was 17.2. Does it really vary that much? Dehydration?

Hard to know.